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Smile-on News

No evidence flossing works with gingivitis or periodontitis

17 July 2015

The advice and support given to patients by dental professionals may have to be radically overhauled after compelling evidence was heard at the 11th European Workshop in Periodontology. The conclusion drawn there was that dental floss is not effective in plaque removal or in reducing inflammation in patients with periodontitis.

Researchers from last November’s event has now challenged the dental hygiene community to accept evidence that shows inter-dental brushes (IDBs) have demonstrated effectiveness in reducing plaque and inflammation, whereas flossing, which provides no evidence in this respect, cannot be recommended “other than for sites of gingival and periodontal health, where IDBs will not pass through the interproximal area without trauma.”

Chair of the Workshop working group, Professor Iain Chapple, said: “What it means for the profession is that we’re going to have to change our mindset and our behaviour to accepting that floss doesn’t have any value in patients who have had periodontitis or those who have gingivitis.

“Essentially, we are going to have to get over the fact that this is what the evidence tells us and start recommending the inter-dental brushes instead of floss for patients with gingivitis and those with a history of periodontitis, provided they fit between the spaces.

“We found no evidence that the use of dental floss in patients who have gingivitis or periodontitis confers any benefit whatsoever in terms of efficacy. The flossing story appears to be a big myth.”

He stops short, however, at dismissing the value of floss entirely, indicating that it may still have a role to play. He added: “But the only role it would appear to have to play is where we have no gaps between the teeth and we have a healthy situation, and when in that situation it may not be possible to use other devices.

“For many many years people have advocated dental floss for patients who have periodontitis or gingivitis and this is almost ingrained into the mindset of the dental hygienist and therapist and oral health educator. What this workshop is telling us is that there is no evidence for that in those situations at all. The only evidence we have is related to use of inter-dental brushes.”